Lapses in hospital infection infection-control practices appear to be magnifying Saudi Arabia's recent steep rise in Middle East respiratory syndrome coronavirus (MERS-CoV) infections, according to an expert team from the World Health Organization (WHO) that just completed a visit to the country that included two hospitals.

The WHO said in a statement today that its team just completed a 5-day mission to Saudi Arabia to explore the reasons for the recent gush of cases. In late April the WHO offered its assistance, and Saudi health officials invited the expert team to visit.

The experts met with health officials in Riyadh to explore the epidemiologic, disease prevention, organizational, and communication components of the outbreak to better gauge the public health risk and to suggest the next steps for curbing the disease.

Afterward, the team visited two of Jeddah's main hospitals to investigate transmission patterns and review infection control practices. Hospital-based outbreaks in both Jeddah and Riyadh have made up a large part of the recent surge, and dozens of healthcare workers are among the reported cases.

I posted the photo from Arab News on May 19, 2013, and it struck me then as a dreadful, embarrassing, very unfortunate example of Saudi infection control and health communication. Nothing they've done since has seriously changed my opinion.

The Saudis are far from stupid, and I've tried to figure out why they would behave in this painfully stupid way. Being an arts guy, not a medical guy, I recall a distinction made by Canada's greatest scholar, Northrop Frye. Frye discussed "ego art" versus "self art," and I think we have here a case of "ego health communication" versus "self health communication."

To paraphrase the master very crudely, Frye argued that the ego is always insecure and accepts others only as an uncritical audience. Its only message is: "Here I am, pay attention, aren't I great?" (And if you don't think I'm great, a thousand lashes and ten years in jail!)

The self, however, is pretty comfortable with who it is, and more interested in others than the ego can dream of being. The self actually invites and likes criticism: "Whoah, I hadn't thought of that. Interesting and helpful, and thanks!"

Insecure, ego-driven health systems are obsessed with framing their communication strategy as "Chill out, I got this." This is the default state of anyone who can stand anything but embarrassment.

A self-driven health system, by contrast, knows that it's operating from a state of near-total ignorance; Pasteur is almost within living memory, and the more we learn the more we realize how little we've learned since then.

Instead of beating itself up for not being perfect, such a system turns to the world and says: "This is what we know so far. It's not as much as we'd like, but we're working on it and we'd be grateful for your suggestions."

If the Saudis can ever move from ego to self, I suspect they'll vastly improve their healthcare systems and much of their society in general. They might even decide they can throw away their whips.

Lapses in hospital infection infection-control practices appear to be magnifying Saudi Arabia's recent steep rise in Middle East respiratory syndrome coronavirus (MERS-CoV) infections, according to an expert team from the World Health Organization (WHO) that just completed a visit to the country that included two hospitals.

The WHO said in a statement today that its team just completed a 5-day mission to Saudi Arabia to explore the reasons for the recent gush of cases. In late April the WHO offered its assistance, and Saudi health officials invited the expert team to visit.

The experts met with health officials in Riyadh to explore the epidemiologic, disease prevention, organizational, and communication components of the outbreak to better gauge the public health risk and to suggest the next steps for curbing the disease.

Afterward, the team visited two of Jeddah's main hospitals to investigate transmission patterns and review infection control practices. Hospital-based outbreaks in both Jeddah and Riyadh have made up a large part of the recent surge, and dozens of healthcare workers are among the reported cases.

I posted the photo from Arab News on May 19, 2013, and it struck me then as a dreadful, embarrassing, very unfortunate example of Saudi infection control and health communication. Nothing they've done since has seriously changed my opinion.

The Saudis are far from stupid, and I've tried to figure out why they would behave in this painfully stupid way. Being an arts guy, not a medical guy, I recall a distinction made by Canada's greatest scholar, Northrop Frye. Frye discussed "ego art" versus "self art," and I think we have here a case of "ego health communication" versus "self health communication."

To paraphrase the master very crudely, Frye argued that the ego is always insecure and accepts others only as an uncritical audience. Its only message is: "Here I am, pay attention, aren't I great?" (And if you don't think I'm great, a thousand lashes and ten years in jail!)

The self, however, is pretty comfortable with who it is, and more interested in others than the ego can dream of being. The self actually invites and likes criticism: "Whoah, I hadn't thought of that. Interesting and helpful, and thanks!"

Insecure, ego-driven health systems are obsessed with framing their communication strategy as "Chill out, I got this." This is the default state of anyone who can stand anything but embarrassment.

A self-driven health system, by contrast, knows that it's operating from a state of near-total ignorance; Pasteur is almost within living memory, and the more we learn the more we realize how little we've learned since then.

Instead of beating itself up for not being perfect, such a system turns to the world and says: "This is what we know so far. It's not as much as we'd like, but we're working on it and we'd be grateful for your suggestions."

If the Saudis can ever move from ego to self, I suspect they'll vastly improve their healthcare systems and much of their society in general. They might even decide they can throw away their whips.